Bladder biomechanics and the use of scaffolds for regenerative medicine in the urinary bladder

Abstract

The urinary bladder is a complex organ with the primary functions of storing urine under low and stable pressure and micturition. Many clinical conditions can cause poor bladder compliance, reduced capacity, and incontinence, requiring bladder augmentation or use of regenerative techniques and scaffolds. To replicate an organ that is under frequent mechanical loading and unloading, special attention towards fulfilling its biomechanical requirements is necessary. Several biological and synthetic scaffolds are available, with various characteristics that qualify them for use in bladder regeneration in vitro and in vivo, including in the treatment of clinical conditions. The biomechanical properties of the native bladder can be investigated using a range of mechanical tests for standardized assessments, as well as mathematical and computational bladder biomechanics. Despite a large body of research into tissue engineering of the bladder wall, some features of the native bladder and the scaffolds used to mimic it need further elucidation. Collection of comparable reference data from different animal models would be a helpful tool for researchers and will enable comparison of different scaffolds in order to optimize characteristics before entering preclinical and clinical trials.

Bioengineering Approaches for Bladder Regeneration

“…Bladder regeneration through tissue engineering offers important advantages, since it saves time in the operation room, allows the avoidance of gastrointestinal complications, and improves the patients’ quality of life. On the other hand, tissue engineering and regenerative medicine technologies for bladder replacement represent a very promising approach to develop novel therapeutics for other diverse lower urinary tract pathologies which do not necessarily requires complete bladder substitution [ 35 , 36 ]. Thus, many different animal models have been employed to evaluate the effectiveness of different cell-seeded scaffolds for bladder augmentation [ 37 , 38 , 39 , 40 ].…”

Single molecule protein stabilisation translates to macromolecular mechanics of a protein network

“…cell cytoskeletons) with properties such as structural support and repetitive energy dissipation. [8][9][10][11][12][13] For example, a-helical lamin protein domains that define the lattice-like network of the cell's nucleus, provide both crucial structural support, as well as aiding in the coupling of mechanical signals to complex biochemical processes in the cell. 14 The staggered architecture in a collagen microfibril permits energy dissipation through molecular sliding, rather than snapping and can withstand GPa of pressure.…”

Challenges With the Development of Biomaterials for Sustainable Tissue Engineering

“…Although some publications still suggest that there is good potential for tissue engineered bladders (Van Ba et al, 2015), the evidence for optimism is rather scant; some studies suggest a lack of understanding of bladder biomechanics may be a major factor (Ajalloueian et al, 2018). The poor prospects for synthetic biodegradable polymers has been emphasized (Pokrywczynska et al, 2014).…”